Requester's Name


Requester's Company (If Applicable)


Requester's Phone Number


Format: xxx-xxxx (include hyphen)

Requester's Email


Physical Address of Incident


Date of Incident


Notice: In an effort to prevent Spam form submissions, you will need to answer the question what is 1 + 2?
Enter result in the field below to submit your request.

Copyright © Johnston County Emergency Services. All Rights Reserved.

Under North Carolina law, e-mail addresses are public records.
If you do not want your e-mail address released in response to a public-records request, do not send electronic mail to this entity. Instead, contact the office by phone or in writing.

JoCo Government Logo